Uganda Continues to Battle Female Circumcision

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September 10, 2012

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September 10, 2012

KAPCHORWA DISTRICT, UGANDA –Judith Nakitari, Monica Chelimo and Betty Cheboi Akiki were the best of friends as teenagers. Growing up in the rural Kapchorwa district of Uganda, nearly 200 miles from the capital Kampala, the girls did everything together.

When they were 16, all three were forced by relatives and village elders to undergo female circumcision, or female genital mutilation as it more widely known now.

“At that time, there was no one to save you,” Nakitari says. “You had to get circumcised. Fathers would wait for their daughters with spears so that their daughters didn’t embarrass them, in case they cried or ran away.”

Nakitari, the only one of her childhood friends alive today, says they were all scared of the knife but they knew that it was a rite of passage and there was nothing they could do to avoid it. The night of their circumcision, the girls performed the rituals. They danced and sang. They promised not to reveal the secrets of the circumcision, namely the pain. Nakitari says their relatives watched as a crude knife was used to remove each clitoris and outer genitalia.

After the procedure, the girls were made to walk several miles to the location where they were supposed to be nursed by traditional healers. But the healers never came to care for the girls or monitor their wounds. To make matters worse, the girls parents did not adequately pay for the circumcision Nakitari says the circumciser, a local medicine woman, took a piece of each clitoris that she had cut, promising to bewitch the girls if their families never paid her for her service.

Today, more than 30 years later, Nakitari says they were cursed. All three women were plagued by physical and psychological complications throughout their lives.

Female genital mutilation, FGM, is defined as a nonmedical procedure that involves the partial or total removal of the external female genitalia. According to the World Health Organization, WHO, an estimated 130 million girls and women worldwide are currently living with the consequences of FGM. Another 92 million African girls, ages 0 to 10, have already undergone the cut.

Despite the increased awareness and international attention surrounding FGM, an estimated 3 million girls remain at risk of mutilation each year in Africa alone. Several countries, including Uganda, have enacted new laws to outlaw the common cultural practice. But FGM is still practiced in 28 countries in Africa, and a handful of countries in Asia and the Middle East. In Uganda, the Kapchorwa district, where Nakitari is from, is one of the districts where FGM is still practiced despite the new law signed by President Yoweri Museveni earlier this year that prohibits and criminalizes FGM. The law makes provisions to punish the offenders and protect the victims. But as circumcision season approaches, advocates are wondering just how effective the litigation will be in the country’s most rural areas.

The Physical and the Psychological: Post-Circumcision Consequences

Nakitari says her wound eventually healed, but she has had life long numbness in the area. Just one year after her circumcision, she was married and she gave birth to her first son. “I have never enjoyed sex. But I had to give to my husband. It is my responsibility,” she says.

As the months and years passed, all three women began to suffer physical symptoms including abdominal pain, numbness and a host of other symptoms not typically associated with female genital mutilation, like joint pain and partial paralysis. Natkitari says she and her two friends had pain when they walked long distances and did heavy work. Strangely, by 1987, eleven years after circumcision, all three women used walking sticks or crutches to just get around their homes.

Akiki went to Kenyatta Hospital in Kampala where her symptoms could not be diagnosed, but she was given painkillers. Nakitari went to Nsambya Hospital but doctors were also unable to identify her condition. By the early 1990s, all three women were completely crippled. And by 2006, Akiki and Chelimo were dead.

“I sought help from different witchdoctors,” admits Nakitari. “Each time, I was told that I had been bewitched.” While new research suggests that long lasting abdominal pain may be a complication related to female genital mutilation, no current data lists paralysis as a result of female genital mutilation. But for Nakitari, the paralysis and untimely deaths of her two friends have had one positive consequence -- the young girls in Kwomo village now protest the cultural rite of circumcision. “In Kwomo village, no girl will get circumcised, especially if she sees the way I suffer every day,” she says of the now common rumor that she was cursed after her circumcision.

New Era of Advocates Lobby for Change in Hardest Hit Areas

Amina Buraimu, 62, says she has been circumcising young girls in Uganda for decades. She claims to have circumcised more than three million women here. Buraimu disagrees with the now common human rights definition of the procedure – she says it does not cause long-term numbness or pain and it is not a factor in sexually transmitted infections. Though data from the WHO and the United Nations suggests that HIV transmission among FGM victims is high thanks to multiple operations performed with the same knife.

“All the people I have circumcised are well,” she says. “They are married with children and they don’t suffer from STDs.” Buraimu’s claims, of course, cannot be verified, but she highlights an important fact. While the international community and the national government here have become outspoken in favor of banning the practice, it still holds significance on the ground, especially in rural regions and among village elders.

Buraimu says she started “to cut girls” 1978 with guidance from the circumcision spirit. “I heard voices of three women within. They were saying they would kill me if I didn’t circumcise girls. I refused and hid in the forest for days, but the voices continued to haunt me,” she says.

Buraimu says the ritual is important and forces young girls to remain virgins until they are married. “These days, girls have sex before marriage. They insist that they want to enjoy sex with their husbands. That’s why they don’t want to be circumcised,” Buraimu says. Buraimu says she long believed circumcision was a vital cultural practice.

Not so, says Justine Chemutai, a community educator with the Reproductive, Educative and Community Health organization, REACH, that is based in Kampala. “The impact of FGM has proven to be undesirable to females and their families as well,” Chemutai says. REACH has been combating the ongoing practice of FGM since 1996. The group reaches out to clan leaders, village elders, political and religious leaders, traditional healers, and other community based organizations to educate people on the lasting physical and psychological consequences of the practice – from infertility to depression. For Cheborion, chairman of the Sabiny Elders Association, a local organization of tribal leaders who are advocating for change, says, “There is no need to fulfill this custom any more. It has no benefit to the person who has it done.”

Even Buraimu, the circumciser, who was once called Amina Atare, meaning dangerous Amina, has recently abandoned her trade after working with people from REACH for several months to learn how circumcision can be harmful.

Despite the recent successes of the REACH program, Martin Cherukut, a monitor and evaluation officer with REACH, says there are many regions where circumcisions continue unmitigated. In the Kapchorwa district, the topography offers activists and law enforcement the largest challenge. “People can hide in the plains and circumcise. By the time the authority reaches them, they have run away,” Cherukut says. He says another problem is that many circumcisers have resorted to trafficking young girls across the border into Kenya. Or, in other cases, Cherukut says circumcisers will cross the border in from Kenya and return back after they have performed a round of FGMs.

Circumcision Season Approaching

Justine Chemusto, 26, lives in the same district where Nakitari and her friends were circumcised against their will 30 years ago. Chemusto is uncircumcised and says she is proud of it. ”I walk with my head high because I know that nobody will dehumanize me,” she says.

But others may not be as lucky. According to the Sabiny, the dominant tribal group here, calendar, December is the circumcision month. While Sabiny elders and organizations say they are rigorously preaching against FGM, many wonder how many young girls will undergo the circumcision rite in the secluded, rural areas of the country this December. Cheborion of the Sabiny Elders Association says he believes that new law and its enforcement order from local police will protect the girls here. He says the association translated the entire law into KupSabiny, the local language, so that everyone could understand.

But Cherukut of REACH is not as confident. He says there is still a lot of work to do. “Unless all circumcisers are confined in a room in December, other girls will be circumcised in the plains of Mountain Elgon.”

While police say they are on the lookout for signs of the now illegal procedure, change is hard to come by. For Buraimu, who spent her life circumcising women and believing it was her duty, she says now that she has been persuaded to stop she can’t sleep. “I dream of circumcising,” she admits.